Individual
DR. THEODORE JOHN POLTORAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
77 CENTRAL SQ, LINWOOD, NJ 08221-2168
(609) 927-4336
(609) 926-3310
Mailing address
77 CENTRAL SQ, LINWOOD, NJ 08221-2168
(609) 927-4336
(609) 926-3310
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
14481
NJ
Other
Enumeration date
10/23/2007
Last updated
10/23/2007
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